This Article Full Text Full Text (PDF) All Versions of this Article: 92/7/2487    most recent Author Manuscript (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schlumberger, M. Articles by Benhamou, E. Search for Related Content PubMed PubMed Citation Articles by Schlumberger, M. Articles by Benhamou, E. Related Collections Endocrine Oncology Thyroid

Comparison of Seven Serum Thyroglobulin Assays in the Follow-Up of Papillary and Follicular Thyroid Cancer Patients

Institut Gustave Roussy and University Paris Sud (M.S., F.Tr., S.K., M.R., E.B.), Villejuif, France; Centre Henri Becquerel (A.H.), Rouen, France; Hôpital Saint Louis (M.E.T., M.H.S.), Hôpital de la Pitié (L.L.), and Hôpital Cochin (F.Te.), AP-HP, Paris, France; Centre René Huguenin (C.C.), Saint Cloud, France; Hospices Civils de Lyon (F.C., F.B.-C.), Lyon, France; Hopital La Timone (D.T.), Marseille, France; Centre Georges François Leclerc (M.T.), Dijon, France; Institut Bergonié (F.Bo.), Bordeaux, France; Institut Jean Godinot (C.S.), Reims, France; Centre Jean Perrin (C.D.), Clermont Ferrand, France; Institut Paoli Calmettes (I.B.-R.), Marseille, France; Hôpital de San Giovanni Rotondo (M.T.), Italy; Centre François Baclesse (S.B.), Caen, France; Centre Lacassagne (F.Bu.), Nice, France; Hôpital Bretonneau (J.J.G.), Tours, France; Centre Paul Papin (O.M.), Angers, France; Centre Paul Strauss (O.S.), Strasbourg, France; Hôpital Hautepierre (J.L.S.), Strasbourg, France; Hôpital du Mans (A.P.), Le Mans, France; Hôpital de Thionville (D.S.), Thionville, France; and Hôpital de Limoges (F.A.), Limoges, France

Address all correspondence and requests for reprints to: Martin Schlumberger, Institut Gustave Roussy, Rue Camille Desmoulins, 94805 Villejuif Cédex, France. E-mail: schlumbg{at}igr.fr.

Background: Serum thyroglobulin (Tg) is the marker of differentiated thyroid cancer after initial treatment and TSH stimulation increases its sensitivity for the diagnosis of recurrent disease.

Aim: The goal of the study is to compare the diagnostic values of seven methods for serum Tg measurement for detecting recurrent disease both during L-T₄ treatment and after TSH stimulation.

Methods: Thyroid cancer patients who had no evidence of persistent disease after initial treatment (total thyroidectomy and radioiodine ablation) were studied at 3 months on L-T₄ treatment (Tg1) and then at 9–12 months after withdrawal or recombinant human TSH stimulation (Tg2). Sera with anti-Tg antibodies or with an abnormal recovery test result were excluded from Tg analysis with the corresponding assay. The results of serum Tg determination were compared to the clinical status of the patient at the end of follow-up.

Results: Thirty recurrences were detected among 944 patients. A control ¹³¹I total body scan had a low sensitivity, a low specificity, and a low clinical impact. Assuming a common cutoff for all Tg assays at 0.9 ng/ml, sensitivity ranged from 19–40% and 68–76% and specificity ranged from 92–97% and 81–91% for Tg 1 and Tg2, respectively. Using assays with a functional sensitivity at 0.2–0.3 ng/ml, sensitivity was 54–63% and specificity was 89% for Tg1. Using the two methods with a lowest functional sensitivity at 0.02 and 0.11 ng/ml resulted in a higher sensitivity for Tg1 (81% and 78%), but at the expense of a loss of specificity (42% and 63%); finally, for these two methods, using an optimized functional sensitivity according to receiver operating characteristic curves at 0.22 and 0.27 ng/ml resulted in a sensitivity at 65% and specificity at 85–87% for Tg1.

Conclusion: Using an assay with a lower functional sensitivity may give an earlier indication of the presence of Tg in the serum on L-T₄ treatment and may be used to study the trend in serum Tg without performing any TSH stimulation. Serum Tg determination obtained after TSH stimulation still permits a more reliable assessment of cure and patient’s reassurance.

This article has been cited by other articles:

				M. G. Castagna, L. Brilli, T. Pilli, A. Montanaro, C. Cipri, C. Fioravanti, F. Sestini, M. Capezzone, and F. Pacini Limited Value of Repeat Recombinant Human Thyrotropin (rhTSH)-Stimulated Thyroglobulin Testing in Differentiated Thyroid Carcinoma Patients with Previous Negative rhTSH-Stimulated Thyroglobulin and Undetectable Basal Serum Thyroglobulin Levels J. Clin. Endocrinol. Metab., January 1, 2008; 93(1): 76 - 81. [Abstract] [Full Text] [PDF]